February 1, 2010

It’s 11:00 am on the tarmac at the Port-au-Prince Airport and I’m waiting for the C-12 military flight that will begin my trip home. There is a mix of people around me, many in scrubs or nongovernmental organization t-shirts. There are large suitcases and small backpacks. There are many Haitian-Americans. Fatigue and sadness line many of the faces. We share stories of where we have been and what we have seen. We share water and trail mix. We share this experience, though most of us haven’t begun to comprehend what it has meant.

It seems a lifetime ago I was frantically packing my bags and making those last minute trips to REI. I remember the military helicopter from Santo Domingo to the US Embassy and the bumpy SUV ride through the rubble-filled Port-au-Prince streets. I remember my first day as a Medical Team Leader and the chaos at the Haitian Marine base where US Joint Task Force Bravo set up operations—military personnel barking orders in every direction, yelling to be heard over the constant rhythmic beating of helicopter blades overhead. I remember triaging the long lines of patients outside our Relief International clinic gates every morning.

We were all incredibly shocked when the team member returned and told us she’d died shortly after arrival to the referral hospital. His hands shook as he spoke haltingly of finding meaning in being there to comfort Jeanty’s mother as Jeanty slipped from the world.

I struggle with many of the decisions I made as the Medical Team Leader, including those I made the day Jeanty died. I remind myself I made the best decisions I could given the information and resources at hand. I realize in the end, I would make them again. I forgive myself, but will wonder for the rest of my life if things might have gone differently for little Jeanty had I decided to set up our mobile clinic at Tabanacle de Victoire a day earlier.

I don’t think anyone ever knew I spent that night curled up in a ball in my sleeping bag, rocking back and forth under the Haitian sky, tears pouring down my face. I’ve been an Emergency Medicine physician for years, but never before felt such profound and aching awe of what it truly means to hold the lives of others in my hands. What it means to make decisions that may change those lives forever. Never before had I felt the anguish that comes when you can literally see the consequences of your choices, when the names and faces along the road you haven’t chosen come sharply into focus.

Yesterday we dispatched an assessment team to the Fontamara orphanage, only a mile away from our clinic, after receiving word they needed help. All was well. The numerous sick and injured children had finally been taken for medical care when relief workers arrived two days earlier. The remaining children now had food, water, and shelter. Madame Jacques, the children’s elderly caretaker, thanked us for our visit. Then she shared the story of the 56 children who died in the earthquake. She reached into her shiny red purse and brought out glossy 4 by 6 photos of the 16 children whose bodies had been recovered. Forty children remain buried in the concrete rubble that was once their home.

I stood next to Madame Jacques as she passed the photos around. She handled the edges carefully. She didn’t say a word. Face impassive, she pulled out photo after photo of her dead children, their bodies laid carefully next to each other in the dirt. Some were clothed. Some were not. Only a few had obvious injuries. Most just looked asleep, though their bloated bellies and the flies dotting their dust-covered faces suggested otherwise.

We stood together in the shade, silent mourners in this spontaneous memorial service. Sunlight dappled the ground and the faint laughter of the surviving children could be heard in the background. Finally, the stream of photos stopped. I couldn’t help but realize we’d been only a mile away from them for over a week and yet knew nothing of their plight.

I couldn’t speak. I could only take Madame Jacques’ gnarled hand and wonder what might have been. Eyes raw with grief, she gave a single tight nod and tucked the photos away in her shiny red purse. She’d been so busy caring for the living, she’d only just begun to mourn the dead.

I can still see her eyes, dark brown like Jeanty’s. I roll my backpack toward the C-12 with the American flag on the tail. I drag my pack up the steps, throw it on the pile, and settle into my seat.